scholarly journals Barriers and Facilitators of Engaging Community Health Workers in Non-Communicable Disease (NCD) Prevention and Control in China: A Systematic Review (2006–2016)

2018 ◽  
Vol 15 (11) ◽  
pp. 2378 ◽  
Author(s):  
Hongfei Long ◽  
Wenting Huang ◽  
Pinpin Zheng ◽  
Jiang Li ◽  
Sha Tao ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Communicable Disease ◽  
Cost Effective ◽  
Barriers And Facilitators ◽  
Community Based Interventions ◽  
Cost Effective Approach ◽  
Dominant Disease ◽  
Implementation Effect

Background: Non-communicable diseases (NCDs) have become a dominant disease burden in China. Although China has a prevention-centered NCD strategy, the implementation effect in the community has been subjected to manpower and financial difficulties. Engaging community health workers (CHWs) in community-based interventions may be a cost-effective approach to relieve the resource shortage and improve health. This review aimed to synthesize evidence on types of NCD-related care that was provided by CHWs in China, and to identify relevant barriers and facilitators. Methods: A literature search was conducted in Medline, PubMed, ProQuest, and Google Scholar databases for English-written, peer-reviewed articles published from 1996 to 2016 that reported findings from NCD-related interventions delivered by CHWs in China. Each article was extracted independently by two researchers. Results: Twenty distinct studies met the inclusion criteria. The two most common types of CHW-led NCD-related care were diabetes and hypertension management (n = 7) and mental health care (n = 7). Thirteen studies discussed the barriers and 16 studies reported facilitators. The most common barriers included lack of support (n = 6), lack of resources (n = 4), and heavy reliance on technology (n = 4). The common facilitators included an integrated health system (n = 9), community and patient trust (n = 5), high quality training (n = 5), and CHWs’ capacity (n = 5). Fourteen studies mentioned training content, while only eight described detailed procedures and duration. Conclusions: This review suggests that trained and supervised Chinese CHWs had the capacity to provide grassroots NCDs preventive interventions. In order to increase the generalizability and sustainability of such programs, studies with robust designs are needed to explore the effectiveness of CHW-led programs, and the intervention strategies to improve the practice of CHWs in various settings.

Community Health Workers (CHWs) as Innovators

2018 ◽  
Vol 13 (1) ◽  
pp. 15-28
Author(s):  
Tyler Prentiss ◽  
John Zervos ◽  
Mohan Tanniru ◽  
Joseph Tan
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Underserved Populations ◽  
Low Cost ◽  
Cost Effective ◽  
Well Being ◽  
Grant Writing ◽  
Multiple Sources ◽  
Context Of Learning

Community health workers (CHWs) have a longstanding role in improving the health and well-being of underserved populations in resource-limited settings. CHWs are trusted in the communities they serve and are often able to see through solutions on community challenges that outside persons cannot. Notwithstanding, such solutions often must be low-cost, easily implementable, and permit knowledge gaps among CHWs to be filled via appropriate training. In this sense, use of cost-effective information technology (IT) solutions can be key to increasing access to knowledge for these community agents. This paper highlights insights gleaned from a pilot study performed in Detroit, Michigan with a group of CHWs in basic grant-writing training via an e-platform, the Community Health Innovator Program (CHIP). The results are discussed within the context of learning theory. It is concluded that e-platforms are necessary for CHWs to leverage knowledge from multiple sources in an adaptive environment towards addressing ever-evolving global health challenges.

scholarly journals Community-Based Interventions for Stroke Provided by Nurses and Community Health Workers: A Review of the Literature

2020 ◽  
Vol 52 (4) ◽  
pp. 152-159 ◽  
Author(s):  
Gayenell S. Magwood ◽  
Michelle Nichols ◽  
Carolyn Jenkins ◽  
Ayaba Logan ◽  
Suparna Qanungo ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Review Of The Literature ◽  
Community Based Interventions ◽  
Community Based

scholarly journals Effectiveness of service models and organisational structures supporting tuberculosis identification and management in hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e019642 ◽  
Author(s):  
Charlotte C Heuvelings ◽  
Patrick F Greve ◽  
Sophia G de Vries ◽  
Benjamin Jelle Visser ◽  
Sabine Bélard ◽  
...  
Keyword(s):  
Systematic Review ◽  
European Union ◽  
Cost Effectiveness ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Cost Effective ◽  
Service Models ◽  
Hard To Reach Populations ◽  
Organisational Structures

ObjectiveTo determine which service models and organisational structures are effective and cost-effective for delivering tuberculosis (TB) services to hard-to-reach populations.DesignEmbase and MEDLINE (1990–2017) were searched in order to update and extend the 2011 systematic review commissioned by National Institute for Health and Care Excellence (NICE), discussing interventions targeting service models and organisational structures for the identification and management of TB in hard-to-reach populations. The NICE and Cochrane Collaboration standards were followed.SettingEuropean Union, European Economic Area, European Union candidate countries and Organisation for Economic Co-operation and Development countries.ParticipantsHard-to-reach populations, including migrants, homeless people, drug users, prisoners, sex workers, people living with HIV and children within vulnerable and hard-to-reach populations.Primary and secondary outcome measuresEffectiveness and cost-effectiveness of the interventions.ResultsFrom the 19 720 citations found, five new studies were identified, in addition to the six discussed in the NICE review. Community health workers from the same migrant community, street teams and peers improved TB screening uptake by providing health education, promoting TB screening and organising contact tracing. Mobile TB clinics, specialised TB clinics and improved cooperation between healthcare services can be effective at identifying and treating active TB cases and are likely to be cost-effective. No difference in treatment outcome was detected when directly observed therapy was delivered at a health clinic or at a convenient location in the community.ConclusionsAlthough evidence is limited due to the lack of high-quality studies, interventions using peers and community health workers, mobile TB services, specialised TB clinics and improved cooperation between health services can be effective to control TB in hard-to-reach populations. Future studies should evaluate the (cost-)effectiveness of interventions on TB identification and management in hard-to-reach populations and countries should be urged to publish the outcomes of their TB control systems.PROSPERO registration numberCRD42015017865.

scholarly journals Screening and Referral for Postpartum Depression among Low-Income Women: A Qualitative Perspective from Community Health Workers

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Rhonda C. Boyd ◽  
Marjie Mogul ◽  
Deena Newman ◽  
James C. Coyne
Keyword(s):  
Mental Health ◽  
Postpartum Depression ◽  
Focus Groups ◽  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Health Workers ◽  
Academic Community ◽  
Barriers And Facilitators ◽  
Postpartum Women

Postpartum depression is a serious and common psychiatric illness. Mothers living in poverty are more likely to be depressed and have greater barriers to accessing treatment than the general population. Mental health utilization is particularly limited for women with postpartum depression and low-income, minority women. As part of an academic-community partnership, focus groups were utilized to examine staff practices, barriers, and facilitators in mental health referrals for women with depression within a community nonprofit agency serving low-income pregnant and postpartum women. The focus groups were analyzed through content analyses and NVIVO-8. Three focus groups with 16 community health workers were conducted. Six themes were identified: (1) screening and referral, (2) facilitators to referral, (3) barriers to referral, (4) culture and language, (5) life events, and (6) support. The study identified several barriers and facilitators for referring postpartum women with depression to mental health services.

scholarly journals Screening and Treating Malaria in Pregnancy by Community Health Workers in Benin, Burkina Faso and Gambia: Profiles, Perceptions and Time Commitments

2020 ◽  
Author(s):  
Laetitia Duval ◽  
Elisa Sicuri ◽  
Susana Scott ◽  
Maminata Traoré ◽  
Halidou Tinto ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Community Health ◽  
Malaria Transmission ◽  
Community Health Workers ◽  
Health Workers ◽  
The Gambia ◽  
Malaria In Pregnancy ◽  
Community Based Interventions ◽  
Community Based ◽  
In Pregnancy

Abstract Background To date, there have been few studies on the roles and challenges that community health workers (CHWs) face when encouraging pregnant women to attend health facilities and provide community-based interventions including scheduled screening and treatment (CSST) for malaria. This study investigates the characteristics, daily activities and time commitments of CHWs tasked with delivering CSST as part of a cluster-randomized controlled trial in Benin, Burkina Faso and Gambia. Methods 45 CHWs were interviewed and observed in three rural settings in West Africa, both during and outside the malaria transmission seasons. Results CHWs in all three settings were predominantly male, over 30 years old and relied on farming for income. Most had completed secondary school in Benin (77%) but not in Burkina Faso (33%) or The Gambia (27%). In Benin, most had been in post between 5 to 10 years; in Burkina Faso and The Gambia the majority had been CHWs for over 10 years. CHWs in Burkina Faso received the highest monthly financial reward for taking part in the trial (US$40), next was Benin (US$22.60) and finally Gambian CHWs received US$11. While the CHWs welcomed the increased training, knowledge and skills they acquired on screening and treating malaria in pregnancy afforded by the trial, they also expressed concern about the transportation challenges of successful community-based interventions in remote areas. CHW duties were a bigger time commitment in Burkina Faso than Benin. The time committed to CHW activities (trial and non-trial) was longer during than outside the malaria transmission season. Conclusions This study highlights the importance of taking into account the variety of existing CHW responsibilities when designing and implementing evidence-based policy to address malaria in pregnancy. The findings emphasise the need to consider both financial and non-financial factors likely to impact the scale-up and sustainability of interventions beyond trial conditions.

scholarly journals A17044 Community health workers for non-communicable disease interventions in the digital age

2018 ◽  
Vol 36 ◽  
pp. e339
Author(s):  
Shiva Raj Mishra ◽  
Charilaos Lygidakis ◽  
Dinesh Neupane ◽  
Bishal Gyawali ◽  
Salim S. Virani ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Communicable Disease ◽  
Digital Age ◽  
Non Communicable Disease

scholarly journals Barriers and facilitators to neonatal health and care-seeking behaviours in rural Cambodia: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035449 ◽  
Author(s):  
Gabriella Watson ◽  
Kaajal Patel ◽  
Daly Leng ◽  
Dary Vanna ◽  
Sophanou Khut ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Barriers And Facilitators ◽  
Neonatal Health ◽  
Care Seeking ◽  
Focus Group Discussions ◽  
Group Discussions

ObjectivesNeonatal mortality remains persistently high in low-income and middle-income countries. In Cambodia, there is a paucity of data on the perception of neonatal health and care-seeking behaviours at the community level. This study aimed to identify influencers of neonatal health and healthcare-seeking behaviour in a rural Cambodian province.DesignA qualitative study using focus group discussions and thematic content analysis.SettingFour health centres in a rural province of Northern Cambodia.ParticipantsTwenty-four focus group discussions were conducted with 85 community health workers in 2019.ResultsCommunity health workers recognised an improvement in neonatal health over time. Key influencers to neonatal health were identified as knowledge, sociocultural behaviours, finances and transport, provision of care and healthcare engagement. Most influencers acted as both barriers and facilitators, with the exception of finances and transport that only acted as a barrier, and healthcare engagement that acted as a facilitator.ConclusionUnderstanding health influencers and care-seeking behaviours is recognised to facilitate appropriate community health programmes. Key influencers and care-seeking behaviours have been identified from rural Cambodia adding to the current literature. Where facilitators have already been established, they should be used as building blocks for continued change.

scholarly journals Multi-level community interventions for primary stroke prevention: A conceptual approach by the World Stroke Organization

2019 ◽  
Vol 14 (8) ◽  
pp. 818-825 ◽  
Author(s):  
Michael Brainin ◽  
Valery Feigin ◽  
Philip M Bath ◽  
Epifania Collantes ◽  
Sheila Martins ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Community Health ◽  
Community Health Workers ◽  
Stroke Prevention ◽  
Health Workers ◽  
Cost Effective ◽  
Lifestyle Changes ◽  
Prevention Strategy ◽  
Lipid Lowering ◽  
Prevention Strategies

The increasing burden of stroke and dementia emphasizes the need for new, well-tolerated and cost-effective primary prevention strategies that can reduce the risks of stroke and dementia worldwide, and specifically in low- and middle-income countries (LMICs).  This paper outlines conceptual frameworks of three primary stroke prevention strategies: (a) the “polypill” strategy; (b) a “population-wide” strategy; and (c) a “motivational population-wide” strategy.  (a) A polypill containing generic low-dose ingredients of blood pressure and lipid-lowering medications (e.g. candesartan 16 mg, amlodipine 2.5 mg, and rosuvastatin 10 mg) seems a safe and cost-effective approach for primary prevention of stroke and dementia.  (b) A population-wide strategy reducing cardiovascular risk factors in the whole population, regardless of the level of risk is the most effective primary prevention strategy. A motivational population-wide strategy for the modification of health behaviors (e.g. smoking, diet, physical activity) should be based on the principles of cognitive behavioral therapy. Mobile technologies, such as smartphones, offer an ideal interface for behavioral interventions (e.g. Stroke Riskometer app) even in LMICs.  (c) Community health workers can improve the maintenance of lifestyle changes as well as the adherence to medication, especially in resource poor areas. An adequate training of community health workers is a key point. Conclusion An effective primary stroke prevention strategy on a global scale should integrate pharmacological (polypill) and lifestyle modifications (motivational population-wide strategy) interventions. Side effects of such an integrative approach are expected to be minimal and the benefits among individuals at low-to-moderate risk of stroke could be significant. In the future, pragmatic field trials will provide more evidence.

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